This proposal addresses the need to improve health care quality through the implementation of patient centered outcomes research and by making health care safer. We do this by implementing a significant informatics based practice improvement process in the ambulatory setting, the use of automated online interpreting combined with asynchronous telepsychiatry consultations. There is a pressing national need to provide higher-quality, more effectively accessible language interpretation services to improve the health outcomes of the 4.7% of the US population who have limited English proficiency (LEP) and who currently, as a result, have increased rates of hospital admissions, misdiagnosis, improper treatment and poorer health comprehension and outcomes. This project addresses a critical component of this problem: the need to improve access to high quality, mental health services for diverse populations by improving the flow of clinical work across care settings (primary care and specialty care) through the use of online asynchronous methods of communicating. We have already created and demonstrated an efficient, provider compatible, administratively simple health IT solution: Asynchronous Telepsychiatry (ATP). In this study we will perform a clinical trial to demonstrate and validate a novel method of clinical language interpretation by using an automated online language interpreting tool we have developed with 100 Hispanic patients who have limited English proficiency (LEP). We will also compare this method for diagnostic accuracy, inter-rater reliability, patient satisfaction and language and syntax accuracy measures with the traditional in- person method of interpreting using a trained professional interpreter. This highly innovative proposal builds logically on our prior feasibility studies. The potential impact of this study is far-reaching if we find automated asynchronous language interpretation to be an improved, more easily accessible method of clinical interpretation that is acceptable to, or preferred by, LEP patients than current in- person approaches. The automated translation approach we are using has the potential to dramatically expand clinical capacity nationally and worldwide by reducing the need for on-site interpretation services. While we are testing and evaluating our approach with Spanish-speaking patients in the field of psychiatry, this technical approach can be generalized towards primary care and other medical disciplines and could be applied to many other languages, as well as beyond the healthcare field.